RESISTANT FUNGAL INFECTIONS

RESISTANT FUNGAL INFECTIONS :

1. What are fungal infections ?

Many fungi are parasites for plants, animals, human, and other fungi. Some fungi can cause diseases in humans, several of which may be fatal if left untreated. These include aspergillosis, candidosis, coccidioidomycosis, cryptococcosis, histoplasmosis, mycetomas, mucormycosis, and paracoccidioidomycosis. The so-called dermatophytic and keratinophilic fungi can attack eyes, nails, hair, and especially skin and cause local infections such as ringworm and athlete’s foot. Fungal spores are also a cause of allergies, and fungi from different taxonomic groups can provoke allergic reactions.

2. What do you mean by resistance?

Ability of organisms to grow in presence of drug which is meant to kill of inhibit its growth.

3. What are the causes of emergence of resistance in fungal infections ?

CAUSES OR MISTAKES MADE BY CLINICIANS THAT CAN LEAD TO RESISTANCE AND NONRESPONSIVE TO TREATMENT

1. A common mistake that many clinicians make is to prescribe combination antifungal corticosteroid products for the treatment of common fungal skin infections without confirming the diagnosis. This course of action is not recommended for several reasons:

●Topical corticosteroids can exacerbate tinea infections and may contribute to treatment failure, especially when infections are due to Microsporum species . The use of a potent corticosteroid preparation in a combination product may alter the clinical appearance of a dermatophyte infection. This makes the diagnosis of the underlying disease more difficult

●Some conditions, like tinea cruris, may require antifungal treatment for several weeks; using a combination product puts the patient at risk unnecessarily for side effects, such as skin atrophy, from topical corticosteroids.

●Combination products are far more expensive than simple antifungal agents, or even generically available corticosteroid preparations.

2. Clinicians should avoid the use of nystatin for the treatment of tinea infections. Nystatin is effective for cutaneous candidal infections, but not for the treatment of dermatophytes.

3. Treatment of fungal infections is long term chances of development of resistance occurs if its given or taken for less than is recommended. Poor adherence to long-term treatment regimens using topical antifungal drugs is one of the common causes of relapses following cessation of the antifungal treatment.

4. Acquisition of resistance, can also occur in the case the infections are treated with relatively low drug concentrations.

6.Tinea cruris is a dermatophyte infection of the groin. Topical antifungal therapy is usually sufficient for resolving the local infectio it should accompany preventive behavioral changes and treatment of concomitant tinea pedis or onychomycosis to reduce the risk for future recurrences. (See ‘Tinea cruris’ above.)

4. What can be done ?

Widespread use of the limited numbers of antifungal agents, particularly the azoles, to treat systemic fungal infections has led to the development of drug resistance. Thus, drug resistance in pathogenic fungi, including the dermatophytes, is of increasing importance. Azole antifungals, unlike terbinafine and naftifine, potentiate resistance development in dermatophytes. This resistance affects not only superficial fungal infections but also systemic disease. Importantly, azole resistance has been encountered in strains present in the environment, which may eventually cause human infections.